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COPD: NUTRITION AND WEIGHT MANAGEMENT Alice Lunt, Health Advisor for BLF and Cardiorespiratory Dietitian at Royal Brompton Hospital, London
This article has been put together by British Lung Foundation (BLF), Charity that promotes lung health and supports those affected by lung disease.
For full article references please email info@ networkhealth group.co.uk
One of the many lung conditions that good nutritional management is important for is chronic obstructive pulmonary disease (COPD). COPD can have an effect on the whole body. It is, therefore, vital that people living with the condition maintain a healthy weight and eat a balanced varied diet. This will help with maintaining strength and fitness, as well as supporting the body with fighting infections.1 Food provides the body with energy, including energy to breathe. At rest, COPD patients need to use up to an additional 15% of energy compared with a healthy person, to compensate for the extra physical effort required to breathe. This equates to an estimated additional 430-720 calories per day. Should these additional calories not be consumed, the patient will experience significant weight loss and be at an increased risk of cachexia.2 It has been estimated that around 21% of individuals with COPD (up to 630,000 people) are at risk of malnutrition.3 Conversely, COPD can lead to weight gain due to patients becoming less physically active. Carrying additional body weight increases their risk of cardiovascular disease, high blood pressure, high cholesterol and diabetes. Despite this, most current guidelines and evidence focus on being underweight and malnutrition, rather than general optimal health or being overweight. Facts about COPD in the UK: • It is a group of lung conditions where inflammation and damage cause the airways to be narrowed, making it difficult to empty air out of the lungs. • This includes emphysema and chronic bronchitis. • After asthma, COPD is the second
most common lung disease. • Estimated 1.2 million people, or 2% of the population, are living with diagnosed COPD (2011). • Research from BLF also suggests that prevalence is growing. • There is higher prevalence in the North and Scotland than the South of the UK. • Someone is newly diagnosed with COPD every five minutes.4 MAINTAINING A HEALTHY WEIGHT
Someone with COPD may find their weight increases due to being less physically active and, in those needing steroidal medications, their appetite may increase. If a COPD patient is overweight they will require more effort to breathe and move around. Stored fat compresses the lungs making physical activity harder. Bending also becomes very difficult and leads to breathlessness. A Body Mass Index (BMI) of between 20 and 30kg/m2 is a healthy weight for someone with COPD. Alternatively, waist circumference measurement may be more useful (see Figure 1 overleaf). There are a number of practical tips to help patients make dietary changes. Recommend that they: • check portion sizes and try using a smaller plate; • fill up on vegetables or salad - these should cover about half the plate; www.NHDmag.com June 2017 - Issue 125
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